Mitigating Vaccine Disparities Through Faith-Based Intervention: A Pre-Post Analysis of Recombinant Zoster Vaccine...

The incidence of herpes zoster (HZ) is increasing globally. Despite the availability of a highly effective recombinant zoster vaccine (RZV), vaccination rates are still low in the United States, especially among racially and ethnically minoritized (REM) and socially vulnerable groups. There is an urgent need to identify obstacles to vaccination in these communities and develop effective strategies to increase confidence in the RZV.

From August 2024 to December 2024, we conducted a community-based educational intervention in San Bernardino County, California, partnering with five churches in neighborhoods with high Centers for Disease Control and Prevention (CDC) Social Vulnerability Index scores. The intervention included a 45-min presentation on HZ, its complications, and RZV recommendations. Participants aged 18 + completed pre- and post-surveys to assess attitudes, knowledge, and behaviors. Descriptive statistics summarized outcomes, while a two-proportion Z-test and Fisher's exact test evaluated changes in vaccine literacy.

A total of 156 individuals completed the pre-intervention survey, and 134 completed the post-intervention survey. All identified as REM, with 99% in vulnerable neighborhoods. Sixty-three percent had at least one co-morbid illness, and 46% had received info about HZ or RZV before the session. At baseline, 57% believed they were at risk of HZ, but 75% found the education session "extremely effective" in reassessing their risk. Significant improvements in vaccine literacy, especially regarding disease and age-based recommendations, were observed, with correct responses increasing post-intervention (p < 0.05). Following the intervention, 82% reported a high likelihood of receiving RZV, and 90% a high likelihood of recommending it.

This study demonstrates the feasibility and acceptability of a faith-based, community-led educational intervention to address barriers to RZV uptake among vulnerable REM populations. Using trusted community infrastructure can support equitable expansion of adult immunization programs to reduce preventable HZ disparities.